“We needed something to say,” recalled one of the advisers involved in the discussion. “I can’t tell you how little thought was given to that thought other than it sounded good. So they just kind of hatched it on their own. It just happened. It wasn’t like a deep strategic conversation.”…

Favreau, who would go on to become the chief White House speechwriter, said they wanted Obama “to say something bold and ambitious about health care.”

“He had previously talked about how every year and every election we keep talking about health care and nothing ever happens,” Favreau said. “So we came up with that promise, really one of the first.”

The candidate jumped at it. He probably wasn’t going to get elected anyway, the team concluded. Why not go big?

“In the 2008 campaign, affordable, universal health care for every single American must not be a question of whether, it must be a question of how,” Obama said at the Families USA conference. “We have the ideas, we have the resources, and we must find the will to pass a plan by the end of the next president’s first term.”